St. Jude Medical Center
890 Health Parkway, Suite 200 · Tel +1 (800) 555-0199
MEDICAL FITNESS CERTIFICATE
Patient full name
John Doe
Place of employment
ABC Corporation
Examination date
2026-06-19
Department / ward
General Medicine
Attending physician
Dr. Smith
Medical license / NPI
NPI 1234567890
Date of birth (or ID)
1980-01-01
Employer contact (optional)
hr@abccorp.com
Medical tests performed
No tests added yet
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Complete Blood Count (CBC)
Lipid Panel
Liver Function Test (LFT)
Renal Function (Creatinine/BUN)
Thyroid Stimulating Hormone (TSH)
Hemoglobin A1c
Vitamin D 25-Hydroxy
Urinalysis
ECG / EKG
Chest X-Ray
Pulmonary Function Test (PFT)
Hepatitis Panel
HIV Screening
Tuberculosis (TB) Skin Test
Drug Screen
Physical Examination
Vision Test
Audiometry (Hearing Test)
Stress Test
Other
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Doctor’s note / assessment
Patient is in good health. Fit for duty.
✅ FIT FOR EMPLOYMENT
No restrictions
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